Exhibit 3 - Vendor Disclosure Statement Form.pdf

This is a Vendor Disclosure Statement Form issued by the State of Colorado on January 24, 2008, pursuant to Colorado Revised Statute 24-102-206. The form applies to all state contracts and solicitations for services executed after August 3, 2007, and requires vendors to disclose whether any services under the contract or subcontracts will be performed outside the United States or Colorado. If services are anticipated to be performed outside these geographic boundaries, vendors must identify the specific country or state where work will be performed and provide justification for why it is necessary or advantageous to perform the contract work outside the United States or Colorado.

The form exempts certain contract types from the disclosure requirement, specifically those related to Medicare, the Colorado Medical Assistance Act, the Children's Basic Health Plan Act, and the Colorado Indigent Care Program. Vendors must provide their name and the contract routing number when submitting the completed form to the contracting agency. This disclosure requirement establishes transparency regarding offshore or out-of-state service delivery and ensures state oversight of contract performance locations.